Comment on Aamir Khan's episode on medical practice

Dear Aamir

Happy to see you raise the issue of medical malpractice and lack of ethics in the medical profession. The natural corollary of this should have been a strong message for regulation of medical practice and the profession. It was heartening to see that the failures of MCI projected. For your information the Maharashtra Medical Council took away the license of one doctor, Dr. Shriram Lagoo, incidentally who never practiced medicine! Was happy to see Dr. Gulati but was disappointed that you were advertising for Dr. Devi Shetty and the model of the Arogyashri/Yeshahswani types of insurance which is further destroying the public health model and encouraging huge malpractices like the unnecessary surgeries  of hysterectomies, cardiac bypasses for very low level of blockages by misreporting results, or sometimes the surgeries only happening on paper similar to the basin tests you talked about. The height of malpractice was in UP where insurance passed claims for hysterectomies in men and prostrate surgeries in women!!

Further while it was great to see Dr. Samit Sharma and his outstanding work, It would have been better if you had also discussed the Tamil Nadu model where the focus is on strengthening public health facilities and assuring that all medicines are available free to those who come to the public health system. The Rajasthan model is important to the extent that it helps regulate markets but it cant be an ultimate solution. You yourself agreed with Dr. Gulati that the same kind of healthcare should be available to all whether poor or rich. It would have been great if you had projected some success stories of the public health system.

Response to Aamir Khan's Satyamev Jayate

Aamir Khan’s thoughts in his column in HT’s 7^th May edition titled Daughters are Precious and his 6^th May launch of Satyamev Jayate has seen a lot of euphoria (never mind the copying of the tune of the Euphoria band) being expressed all around. He is the new hero to take up cudgels for lost social causes and stir the emotions and guilt of the middle classes. He does this indeed very successfully.

The first episode deals with the burning issue of sex selection which has created a gender disaster in India. The child sex ratio over the last four decades has witnessed a rapid descent leading to a huge deficit of the girl child in Indian society. Aamir Khan has captured this social disaster very well with powerful cases being brought into our drawing rooms that shame us and overwhelm us with guilt and tears. (Dil pe lagegi as Aamir tells us). The daughter aversion depicted through the cases are indeed a very powerful exposure of the social ills linked to patriarchy but two very powerful by products of this message will cause more harm than good.

The first is the use of the term female feticide. Yes female feticide should not happen but the actual problem is sex selection facilitated by the use of medical technologies by medical professionals. The second is the undue emphasis on abortions and relating it to killings. The two taken together is not only an emotional trap but also fodder for the right wing enthusiasts. I am afraid the womens’ right to abortion comes under threat by projecting such a stance. Aamir and his research team perhaps lack the expertise to vet such sensitivities – the program development when tackling such sensitive social issues, and I believe the forthcoming ones would be even more so, needs consultation and debate with appropriate experts/activists who have devoted their lives to these issues.

Fortunately the column in HT refrains from discussing feticide and abortion and looks more at female discrimination within our social customs and mores. Again the views of Aamir in this column are well appreciated but like the TV show the column too has failed to take head on the root cause of this malevolence.

While there may still be a lot of social acceptance for sex-selection in our patriarchal world, the real perpetrators of this crime (yes it’s a crime today because there is a law that prohibits sex-selection and sex-determination) is the medical profession. Neither the TV show nor the column deals with the role of medical professionals as being central to this heinous issue. The complete absence of ethics in medical practice and the unfettered commercialization of medical care is the root cause for the deficit of girls we face today. If the doctors learn to say NO then the problem will be taken care of substantially. I say substantially because the misuse of medical technology is only one, though the overwhelming axis of the problem. The other axis is the post-birth discrimination and elimination of girls which also needs to be dealt with through social action.

The humungous documentation through sting operations by the two journalists from Jaipur was shown on the TV program and I think that is the real target for action. While I have no problems with writing letters to a chief minister, and why only Rajasthan – the sting operations were across 8 to 10 states, the focus of the larger public action must be on the medical profession. Doctors have to be booked like they did in South Korea.

Finally something about the audience also made me uncomfortable. There was no significant participation from the audience except for the emotional expression of tears which have been used impactfully by the program designers. To me things looked staged, even the few contributions of the external audience, like the comment on Salman Khan. I guess creating the drama around this program is part of the strategy but it could obviate away from the main cause and the proposed action.